To our knowledge, this is the first study to identify a link between frequency of daily brushing and dry mouth and suggests that tooth brushing should be encouraged in high-risk dependent Japanese elderly (65-84 years), particularly those taking antidepressants and/or diuretics.

The short-term effects of various oral care methods in dependent elderly: comparison between toothbrushing, tongue cleaning with sponge brush and wiping on oral mucous membrane by chlorhexidine Objectives: To explore the short-term effects from toothbrushing, tongue cleaning with sponge brush and wiping on oral mucous membrane by chlorhexidine. Background: Numerous reports have been seen in recent years proving the effectiveness of mouth cleaning with a toothbrush for the prevention of respiratory infections among the dependent elderly. However, the short-term effects from each oral care method have not yet been clarified. Hence, an investigation was conducted by having each subject independently perform various oral care methods for five consecutive days. Materials and Methods: The subjects consisted of 12 assistance-dependent elderly who have difficulties with tooth brushing by themselves, have 10 or more residual teeth and are not yet using plate dentures. After the pre-intervention examination, each of the following oral care methods were performed on the same subject on an approximately three week basis: 1) Tooth brushing 2)Tongue cleaning with sponge brush 3)Wiping on oral mucous with sponge brush by chlorhexidine. Each method was performed independently, once a day for 5 consecutive days and the subjects were reexamined on the sixth day for comparative verification. Results: Consequently, toothbrushing decreased the plaque index and gingival index significantly and an improvement of oral malodour was also acknowledged (p < 0.01). Tongue cleaning with a sponge brush decreased the tongue coat score significantly (p < 0.05) and oral malodour was also improved (p < 0.01). Wiping on oral mucous with a sponge brush soaked in chlorhexidine significantly decreased opportunistic infections in the pharynx region (p < 0.05). Conclusions: It was suggested that the use of not only a toothbrush but also chlorhexidine gluconate may be indicated for dependent elderly people in whom pathogens of opportunistic infection are detected.

Dry mouth of the dorsum of the tongue in elderly requiring care was associated with the degree of incapacity, tube feeding, and level of conversation.

Decision tree analysis and logistic regression suggest that the leading contributors to the formation of the membranous substances were the method of ingesting nutrients, dryness of the tongue dorsum and open mouth. These three factors are related to elderly persons requiring nursing care with impaired oral cavity function, and it was suggested that dryness of the oral mucosa was the major factor behind the membrane formation.

When eating food containing both liquid and solid phases (two-phase food), the liquid component frequently enters the hypopharynx before swallowing, which may increase the risk of aspiration. We therefore tested whether preswallow bolus transport and swallow initiation would change as the viscosity of two-phase food was increased. Fiberoptic endoscopy was recorded while 18 adult subjects ate 5 g of steamed rice with 3 ml of blue-dye water. Liquid viscosity was set at four levels by adding a thickening agent (0, 1, 2, and 4 wt%, respectively). We measured the timing of the leading edge of the food reaching the base of the epiglottis, as well as the location of the leading edge at swallow initiation. As viscosity increased, the leading edge of the food reached the epiglottis significantly later during chewing and was higher in the pharynx at swallow onset. The time after the leading edge reached the epiglottis did not vary among the viscosities of the two-phase food. This study found that the initial viscosity of two-phase food significantly altered oropharyngeal bolus flow and the timing of swallow initiation. Accordingly, increased two-phase food viscosity may delay food entry into the pharynx and be of use in dysphagic diets.